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Öğe Assessment of Comorbid Psychopathologies, Psychosocial Factors and Psychiatric Treatment Approach in Children and Adolescents with Sleep Bruxism(2024) Abanoz, Elif; Şireli, Özlem; Ucuz, İlknur; Cicek, Ayla UzunBackground: Previous studies have revealed a close relationship between a variety of psychopathologies and psychosocial factors, and bruxism. However, psychosocial factors and psychiatric difficulties in children and adolescents with bruxism have not been extensively studied. In the current study, we sought to examine the sociodemographic characteristics, psychosocial factors, and comorbid psychopathologies of children and adolescents with sleep bruxism. Materials and Methods: The study included 67 children and adolescents between the ages of 4-17 who were diagnosed with sleep bruxism and followed up at two different Child and Adolescent Psychiatry outpatient clinics between 2018 and 2024. Data on behavioral and emotional characteristics and comorbid psychiatric disorders of these patients, clinical features of bruxism, and treatment approaches to bruxism were retrospectively investigated. Results: Our results indicated that 41.8 of the sample had at least one comorbid psychiatric disorder, and 10.4% had subthreshold psychiatric symptoms. The most common comorbid psychiatric disorders were anxiety disorders, attention deficit hyperactivity disorder, nocturnal enuresis, and conduct disorders. In 41.8% of cases, bruxism was linked to psychosocial factors. Comorbid psychiatric disorders were significantly more prevalent in the school and adolescent age groups than in preschoolers. Similarly, the connection between bruxism and psychosocial factors became more evident with age. The frequency of a positive family history of bruxism was 44.8%. As treatment options for bruxism, the behavioral approach and pharmacotherapy were preferred in 88.1% of cases, and only the behavioral approach was applied to 11.9%. The most common drugs used in pharmacotherapy were hydroxyzine, tricyclic antidepressants, antipsychotics, atypical antidepressants, and melatonin. In terms of response to treatment, 83.6% of the sample responded (completely or partially), while 16.4% did not respond or were resistant to treatment. Conclusions: This study yielded that psychiatric comorbidity is quite common in the pediatric population with sleep bruxism. The outcomes suggest that bruxism is not only a dental problem but is also associated with a variety of psychopathologies and psychosocial factors. Therefore, health professionals who may encounter bruxism should be aware of the relationship between bruxism and psychopathologies and psychosocial factors. It is recommended that children with bruxism be investigated carefully in a multidisciplinary and holistic approach from a bio-psycho-social perspective and screened for psychosocial and psychiatric difficulties.Öğe Clinical characteristics according to sex and symptom severity in children with selective mutism: a four-center study(Taylor & Francis Online, 2023) Doğru, Hicran; Ucuz, İlknur; Uzun Çiçek, Ayla; Cömertoğlu Arslan, SemihaIntroduction: Clinical information regarding selective mutism (SM), a persistent and debilitating psychiatric disorder, in children is extremely limited. We aimed to examine sociodemographic characteristics and comorbid psychiatric conditions and identify clinical variables associated with sex and SM severity among children with SM. Methods: We analyzed the medical records of 49 children who received treatment for SM in four different tertiary hospitals in Turkey between 2016 and 2021. Children's charts were reviewed to examine clinical characteristics, comorbidities, and response to treatment. Results: Thirty-one children were female, and 18 were male (female:male ratio is 1.7:1). Most children (73.5%) with SM displayed onset of SM in 3-6 years. However, most children (57.1%) were diagnosed between the ages of 7-11. The mean time from onset to diagnosis was 1.69 ± 1.37 years. Females displayed a later onset of SM (6.42 ± 2.40 vs. 4.89 ± 0.96; p= 0.013) and higher comorbidity rates (71% vs. 38.9%, p= 0.039) than males. The vast majority of children received two or more psychiatric diagnoses. Children in the severe group had a longer duration of illness, higher rates of psychiatric comorbidity, speech delay, and treatment resistance. Conclusion: Our study suggests that SM may have different clinical features according to sex and symptom severity of SM. More information about children with SM is needed to understand the development and maintenance of SM.Öğe Does Involvement in Peer Bullying Invite Self-Injury? The Association Between Peer Bullying and Self-Injury in a Clinical Sample(Lippincott, 2023) Uzun Çiçek, Ayla; Ucuz, İlknur; Sarı, Seda Aybüke; Cömertoğlu Arslan, Semiha; Doğru, HicranPrevious studies have linked peer bullying to nonsuicidal self-injury (NSSI). However, the evidence is largely limited to population-based groups. This study examined whether there is a relationship between NSSI and being a victim of peer bullying among adolescents in a clinical sample and how this may be influenced by types of bullying. The sample consisted of 96 outpatients with NSSI and 107 healthy adolescents. The Inventory of Statements About Self-Injury, Peer Bullying Scale, and Rosenberg Self-Esteem Scale were applied. Whereas the scores of each bullying type of adolescents with NSSI were significantly higher, their self-esteem scores were significantly lower. Each victimization score of bullying had a negative correlation with NSSI-onset age and self-esteem scores and a positive correlation with self-injury scores. This study demonstrated that being a victim of any type of bullying is strongly associated with self-injury. It would be advisable to screen adolescents with self-injury for exposure to bullying, and vice versa.Öğe Evaluation of cognitive disengagement syndrome in children with obsessive-compulsive disorder: Clinical implications(Clinical Child Psychology and Psychiatry, 18.04.2023) Uzun Çiçek, Ayla; Ucuz, İlknur; Mercan Işık, Cansu; Temelli, GürkanCognitive disengagement syndrome (CDS) has been found to be associated with internalizing symptoms. Yet, no study thus far has focused on whether there is an association between obsessive- compulsive disorder (OCD) and CDS. The purpose of this study is to examine the symptom frequency and clinical implications of CDS in children with OCD. The study included sixty-one children with OCD and sixty-six typically developing children. Children were evaluated by a semi- constructed diagnosis interview, Obsessive-Compulsive Inventory, Barkley Child Attention Scale, and Stroop test. The frequency of elevated symptoms of CDS, and total time, total error, and total correction scores of the Stroop test were significantly higher in the OCD group compared to the controls. Elevated CDS symptoms were significantly associated with higher OCD symptom prevalence and poorer performance on the Stroop Test. Moreover, poor insight, hoarding symptoms, mental compulsions, and ADHD comorbidity were significantly higher in those with elevated CDS symptoms than in those without CDS in the OCD group. The findings of this study provide clinical implications that CDS symptoms may contribute to deficits in attentional orien- tation, conceptual flexibility, and cognitive processing speed in OCD.Öğe Frequency of headache and related clinical factors in children and adolescents with tic disorders(2020) Çiçek, Ayla Uzun; Ucuz, İlknur; Bolayır, ErtugrulAim: Only a few studies have investigated the comorbid headache in children with tic disorders (TD). In this study, thus, we aimed to examine the frequency and clinical correlates of comorbid headache in TD.Material and Methods: The sample consisted of 98 children and adolescents aged 6–16 years with a diagnosis of any tic disorder and 108 healthy children and adolescents matched for age, gender and sociocultural characteristics. All participants underwent a semi-structured psychiatric interview to establish a psychiatric diagnosis. The diagnosis of headache was made according to thethird edition of the International Classification of Headache Disorders criteria. Also, a specially prepared personal information sheet and Yale Global Tic Severity Scale were applied.Results: Children and adolescents with TD had a significantly higher frequency of headache compared to those in the control group (44.9% vs. 22.2%, p=0.001). The most common type of headache in both groups was migraine. We determined that the rate of diagnosis of chronic tic disorders, percentage of the presence of vocal tics, severity of tics, the proportion of patients takingpharmacotherapy for tics, and the rate of psychiatric comorbidity were significantly higher in patients with a headache than those without headache.Conclusion: The results of our study confirm studies showing suggesting a possible relationship between TD and headache, and supports the proposition that headache is a comorbidity of TD. However, further studies exploring the mechanisms of this relationship are required. It also would be advisable to screen children with TD in terms of headaches.Öğe Investigation of Clinical Features and Comorbid Psychopathologies of Children with Sleep Terrors(2024) Şireli, Özlem; Cicek, Ayla Uzun; Abanoz, Elif; Ucuz, İlknur; Naralan, Yüksel SümeyraMethod: Between 2020 and 2024, 51 children who were diagnosed with sleep terror according to DSM-5 diagnostic criteria in 3 different Child and Adolescent Psychiatry clinics were included in the study. The sociodemographic and clinical characteristics of the cases were examined retrospectively through the files. Results: Of the 51 participants, 30 (58.8%) were male, 21 (41.2%) were female and the mean age at the time of admission was 6.76±1.45 years. It was determined that 15 (29.4%) of the cases slept in a noisy environment and 41 (80.4%) of the cases had their sleep interrupted except for sleep terror attacks. At least one psychiatric disorder was detected in 17 (33.3%) patients, and the most common (9.8%) comorbid psychiatric disorder was attention deficit hyperactivity disorder. It was found that complete retrograde amnesia was significantly higher in preschoolers, and motor activity during the attack, physical injury and/or material damage, and full awakening during the attack were significantly higher in school-age children. It was determined that 64.7% of the parents made the wrong intervention during the attack and off-label medication was used in 29.4% of the cases. Conclusion: In sleep terrors, identification of triggering factors and comorbid psychiatric disorders during the diagnostic evaluation process, psychoeducation of parents in treatment, and selection of appropriate medication for medication are very important.Öğe Sociodemographic variables, clinical characteristics, and treatments in children with trichotillomania in terms of age and gender: a multicenter study(Taylor & Francis Online, 2023) Cömertoğlu Arslan, Semiha; Uzun Çiçek, Ayla; Ucuz, İlknur; Doğru, HicranObjective: Although trichotillomania (TTM) is a common, typically pediatric-onset disorder, data on the phenomenology of TTM in children, accompanying comorbid psychiatric disorders, and treatment options are extremely limited. In our study, it was aimed to investigate these variables and related factors in patients undergoing psychiatric evaluation and follow-up. Method: The study included 79 children and adolescents between the ages of 4 and 17 who were diagnosed with TTM and followed up in four different Child and Adolescent Psychiatry outpatient clinics between 2015 and 2020. The sociodemographic characteristics of these patients, clinical features of the disease, comorbid psychiatric disorders, and treatment approaches have been studied. Results: Our results showed that TTM was more common in girls, hair and eyebrow plucking was the most common, and symptoms and features accompanying TTM changed with age, but not with gender. Again, 79.7% of these children had at least one psychiatric comorbid disorder (most common being anxiety disorders and Attention Deficit/Hyperactivity Disorder), comorbidity was closely related to TTM severity, 93.7% used at least one pharmacotherapeutic agent, and positive response rates to treatment were found to be low. Moreover, TTM severity was found to increase with age and disease duration. Conclusion: Study findings support that clinical presentation, disease severity and comorbidity rates may change with age in children and adolescents with TTM, and early intervention is important to prevent clinical progression/worsening and mental health sequela.Öğe The Prevalence of Comorbid Psychiatric Disorders in Children and Adolescents with Asperger Syndrome(Harran Üniversitesi, 2025) Cicek, Ayla Uzun; Arslan, Semiha; Bozok, Beyza; Sarı, Seda Aybüke; Çolak, Mehmet; Abanoz, Elif; Ucuz, İlknurBackground: Most studies in the literature on comorbid psychiatric conditions in children and adolescents with Asperger syndrome (AS) either consist of individual case reports or have evaluated cases only in terms of a specific comorbid psychiatric diagnosis. Therefore, especially in recent years, there are few studies in the literature examining the comorbidity of all psychi-atric disorders in patients with AS in a holistic manner. The present study aimed to determine the prevalence and types of comorbid psychiatric disorders in a clinic-based sample of 34 children and adolescents with AS. Materials and Methods: Thirty-four children and adolescents with ASÖğe Therapeutic approaches to children with enuresis: A retrospective study(2021) Ucuz, İlknur; Çiçek, Ayla UzunEnuresis is a common pediatric condition and there are different treatment options. This study aimed to evaluate treatment options for enuresis in a sample of the childand adolescent psychiatry clinic. The data and treatment results of 98 patients (mean age: 10.38±2.15 years, range=6-16 years) diagnosed with enuresis between 1 May2015 and 1 October 2020 were retrospectively reviewed. We found that 57 of the patients had previously applied to the hospital for enuresis, and 14 of them have appliedto child and adolescent psychiatry, 10 of them to pediatric surgery, 20 of them to other branches of pediatrics, and 13 of them to the urology clinic. In previous hospitalapplications, behavioral treatment only had been applied to 40.4% of the patients, and pharmacotherapy had been applied in 59.6% of the patients. On the other hand,in the child and ado-lescent psychiatry clinic, 26.5% of the patients received behavioral treatment only, and 73.5% used drugs along with behavioral treatment, and themost frequently preferred drugs were imipramine (oftenest) and desmopressin. Also, the rates of psychiatric comorbidity in those who received medical treatment weresignificantly higher than those who treated behavioral treatment only. In conclusion, this study revealed that different clinical branches apply different treatment approachesto enuresis. In child and adolescent psychiatry, imipramine was the most commonly used agent in medical treatment, and this has been attributed to the high rate ofpsychiatric comorbidity
